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Ask the Anxiety Sisters

Intrusive Thoughts

I have been diagnosed with Obsessive Compulsive Disorder because of constant intrusive thoughts. It started one night when I had a dream about me harming myself. Somehow this dream really messed me up. And while I have never actually tried to harm myself, my anxiety has me constantly thinking “what if?” It sends me into full-out anxiety attacks, which makes me so angry and exhausted. Have you heard of this happening to anyone else? I am currently in counseling but it’s not really helping so far.

Dear OCD Sister,


Yes, we have absolutely heard of OCD with intrusive thoughts. In fact, it is far more common than you might imagine. Many people think of Obsessive Compulsive Disorder (OCD) as excessive hand washing or checking that the stove is really turned off. But, in reality, intrusive thoughts often define this  disorder. And you don’t have to have OCD to experience intrusive thoughts. A major study led by Concordia University found that 94% of people have some intrusive thoughts, the most common of which have to do with self-harm, violence toward others, contamination, and doubt so you are definitely not alone.

The main difference between folks with OCD and other folks is how much these thoughts disrupt their lives. Being anxious about them often makes the thoughts occur even more frequently and for a longer period of time thereby causing major obstacles to daily functioning.

We have a few thoughts to share with you.

  • First and foremost, practice self-compassion. We know it is easy to get angry and frustrated with yourself, but it is important to remember that you did not choose OCD—it is a brain disorder. So speak gently to yourself about it. Instead of “why can’t I stop this?” try “because of my disorder, I am having intrusive thoughts and it is really scary.” In other words, talk to yourself as you would a close friend going through something similar. When you stay calm and gentle, you will be better able to use the techniques you’ve learned in therapy to deal with the thoughts.


  • Speaking of therapy (which is a really important component of treatment for those suffering from OCD), you may want to check that your therapist has some experience and training specifically with OCD. The current gold standard is a treatment protocol known as Exposure and Response Prevention (ERP), which gradually exposes you to your obsession or intrusive thoughts in a safe environment, which starts to decrease the anxiety you feel when you get them. There are, of course, other treatment modalities, but this is the one that is the most researched and relied upon in the OCD community.


  • Medication can be a real game changer in managing the symptoms of OCD. Abs often says that she got her life back when she went on Prozac because her intrusive thoughts really receded. Also, some folks find ERP to be too difficult without the aid of pharmaceuticals—at least in the beginning.


  • Lastly, people have all sorts of intrusive thoughts—some of them frightening and taboo—but the content of the thought is really less important than recognizing that the root of the thought is based in OCD rather than in any connection to reality. In other words, having intrusive thoughts about self-harm does not mean that you want to harm yourself—those thoughts are just the form that your OCD takes. Thoughts are not facts. As such, we find self-talk to be really helpful. Tell yourself, out loud if possible, “These are just thoughts” or “This is just my OCD talking”




  • Maria
    February 4, 2021

    It’s very interesting…

  • Lara T
    June 20, 2021

    When I first started having Intrusive thoughts I had no idea what they were. I used to say they were Daymares like nightmares but while awake. 25 years later I finally found a doc who understood what was happening. I wasn’t just depressed, I have an anxiety disorder, PTSD, and OCD. The past couple of years just getting to heal and know myself again have been difficult yet wonderful! Knowledge is power!

  • Cheryl
    August 14, 2021

    This is So interedting. 3 years ago i had a dream about driving an interstate that i have druven my entire life. It is through a big valley and the road is up really High. I dreamed that i drove right off it! Since then i cannot drive or ride on this interstate. No matter what i do the thoughts wont go away. Now i cant be near any embankments including parks, stadium seats, ect. so frustrating’

  • Cecile Wall
    January 13, 2022

    I have worst scenaRio thoughts when going to Dr. Always presume bad news which sometimes Happens not life threatening but leads to more Drs more meds more tests. Paralyzes me n makes me dysfun Ctional n sick. Have 7 appts between jan and Feb follow/ups and just hate it. My husband Goes with Me. But filled with worry n fear and pandemic exacerbates all being limited socially n in gym classes etc

  • Marcie
    February 28, 2022

    I also have intrusive thoughts they make feel sick to my stomach and like Im going To loose. Control. They are Very scary and make me feel drained after. I get thro them but it is really hard.

  • Theresa
    April 9, 2022

    Myself & children suffer from Anxiety, panic attacks, oCD issues.

  • September 1, 2022

    It’s completely ok to have intrusive thoughts but this can be overcome by therapy. I have came across a very affordable therapy option.

  • Elaine
    October 30, 2022

    Two books that have really helped me are The Imp of the mind by Lee baer and overcoming unwanted intrusive thoughts by sally winston. I refer to them often!


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